Jonathan In a Heartbeat

When a fitness instructor collapses in class, he receives a lifesaving intervention.

One afternoon last summer, 33-year-old Jonathan (not his real name), a part-time fitness instructor who appeared to be the epitome of good health, woke early, as he always did, and jumped into a busy day— without taking a moment to eat.

As the day wore on, Jonathan felt progressively less well—tired, mostly, and out of breath—which he attributed to a lack of food. But later in the afternoon, before he had a chance to grab a bite, he collapsed and lost consciousness—just as he was about to begin a class.

Frightened colleagues called 911, and, when emergency services arrived, they placed a defibrillator on him. The monitor showed that Jonathan was suffering from a heart arrhythmia—his heart was beating irregularly—which was likely the result of a cardiac arrest, a life-threatening condition in which the heart stops beating entirely. Emergency services used the defibrillator to stabilize his heartbeat, intubated him, and rushed him to the emergency department at Robert Wood Johnson University Hospital (RWJUH) Rahway.

Delphine Tang, DO
Delphine Tang, DO

There, he was seen by cardiologist Delphine Tang, DO, who, based on Jonathan’s heart rhythms and EKGs— both before and after defibrillation— was concerned that the young man might have blockages in his heart, a common cause of cardiac arrest. She and her colleagues immediately accompanied him to the hospital’s cardiac catheterization lab, where they looked at the blood vessels in his heart and did, indeed, discover three blockages.

Dr. Tang quickly inserted a stent to open up one of the blockages, along with an intraaortic balloon pump, a temporary device to help the heart move blood around the body. Then, Jonathan was transferred to Robert Wood Johnson University Hospital in New Brunswick, where Dr. Tang inserted a second stent. After nine days, he was able to return home.

Jonathan’s frightening experience came as a shock, not just to him but to his friends and family. If there was anyone who seemed to be in great physical condition, it was Jonathan. How could someone so apparently healthy and fit suffer a serious cardiac event, one that could have easily been fatal?

There was one person to whom the patient’s story wasn’t particularly surprising. After his hospitalizations, he received a visit from a family member who had previously been diagnosed with serious cardiovascular disease. “So it seems that there’s a family history he may not have been aware of,” says Dr. Tang. That’s why, she notes, “It’s so important to know your family medical history.” If your mother had a heart attack and/or required the insertion of a stent before the age of 65 or your father did before age 55, Dr. Tang says that you should consult with a cardiologist to determine your own risk.

It’s also essential to know if you have any other factors that might put you at a higher risk of cardiovascular disease. Those factors include high cholesterol, high blood pressure, diabetes and a history of smoking. “If you have these factors, it might mean that you should be screened a little more often,” says Dr. Tang. “If so, your primary care provider may refer you to a cardiologist for further evaluation.”

You should also know and pay attention to the warning signs of cardiovascular disease, including unusual fatigue and/or breathlessness. Dr. Tang recalls that, in the days before Jonathan’s cardiac arrest, he’d told his wife that he wasn’t feeling himself, again attributing his condition to a lack of sleep, bad diet and overwork. “If you’re experiencing any new signs that are unrelenting, you shouldn’t ignore them,” says Dr. Tang. “Tell your doctor.” It’s also important to take preventive measures, like eating a hearthealthy diet and staying active. In fact, says Dr. Tang, Jonathan “might have experienced a cardiac event sooner had he not been very active.”

Six months after being released from the hospital, Jonathan has an excellent prognosis. He may, at some point, need to have an additional stent implanted to treat that third blockage. And, like all patients receiving a stent, he was ordered to take some time—in most cases, a few days to a week—before resuming everyday activities. Because his normal activity level is, in fact, so high, it was necessary for him to take a little extra time before returning to full capacity. But he’s now back to his highly active former life.

Now, that life will include some new activities, including regular visits to his cardiologist and a new awareness of the important numbers—cholesterol levels, blood pressure and blood sugar—that will help him live many more active years.

Whoever your heart beats for, our hearts beat for you. To connect with a top cardiovascular specialist at RWJUH Rahway, call 888-724-7123.